Influences of load carriage and physical activity history on tibia bone strain

Abstract

Background: Military recruits are often afflicted with stress fractures. The military's strenuous training programs involving load carriage may contribute to the high incidence of tibia stress fractures in the army. The purpose of this study was to assess the influences of incremented load carriage and history of physical activity on tibia bone strain and strain rate during walking.

Methods: Twenty recreational basketball players and 20 recreational runners performed 4 walking tasks while carrying 0 kg, 15 kg, 25 kg, and 35 kg loads, respectively. Tibia bone strain and strain rate were obtained through subject-specific multibody dynamic simulations and finite element analyses. Mixed model repeated-measures analyses of variance were conducted.

Results: The mean ± SE of the runners' bone strain (μs) during load carriages (0 kg, 15 kg, 25 kg, and 35 kg) were 658.11 ± 1.61, 804.41 ± 1.96, 924.49 ± 2.23, and 1011.15 ± 2.71, respectively, in compression and 458.33 ± 1.45, 562.11 ± 1.81, 669.82 ± 2.05, and 733.40 ± 2.52, respectively, in tension. For the basketball players, the incremented load carriages resulted in compressive strain of 634.30 ± 1.56, 746.87 ± 1.90, 842.18 ± 2.16, and 958.24 ± 2.63, respectively, and tensile strain of 440.04 ± 1.41, 518.86 ± 1.75, 597.63 ± 1.99, and 700.15 ± 2.47, respectively. A dose-response relationship exists between incremented load carriage and bone strain and strain rate. A history of regular basketball activity could result in reduced bone strain and reduced strain rate.

Conclusion: Load carriage is a risk factor for tibia stress fracture during basic training. Preventative exercise programs, such as basketball, that involved multidirectional mechanical loading to the tibia bones can be implemented for military recruits before basic training commences.

Keywords: Modeling; Multi-body dynamics; Strain; Strain rate; Stress fracture; Walking.